Eczema herpeticum is a herpes simplex virus infection with disseminated skin involvement superimposed on a pre-existing dermatosis. Dariers disease has been reported to be among the dermatoses susceptible to the sudden onset of a widespread vesicular eruption accompanied by high fever known as Kaposis varicelliform eruption. We report a case of eczema herpeticum in a 46-year-old woman associated with Dariers disease.
Darier Disease* ; Eczema* ; Female ; Fever ; Humans ; Kaposi Varicelliform Eruption* ; Middle Aged ; Simplexvirus ; Skin ; Skin Diseases

PURPOSE: This study was undertaken to review the complications associated with ileostomy, colostomy construction and subsequent closure. METHODS: We retrospectively reviewed 74 patients with ileostomy and colostomy closure from August 1, 1995 to June 30, 1999. RESULTS: The complications of stoma construction occurred in 15 patients (20.3%) among 74 patients: skin problem in 10 cases, prolapse in 4 cases, and stoma necrosis, retraction and stenosis in 1 case, respectively. Factors such as age, underlying pathology, type of stoma did not contribute to the complications of stoma construction. Complications of stoma closure occured in 15 patients (20.3%): wound problem in 9 cases, enterocolitis in 4 cases and anastomotic leakage in 2 cases. With respect to stoma closure, only old age was associated with increased morbidity (P<0.05), rather than method of closure, time interval to closure, or type of stoma. Mean operation time for simple closure was 122.2 minutes and 204 minutes for resection and anastomosis. The mean hospital stay was 9.6 days for simple closure and 13 days for resection and anastomosis. CONCLUSIONS: The morbidity associated with stoma construction and subsequent closure was appreciable. There were no specific risk factors influencing the complications of ileostomy or colostomy construction, but old age increased morbidity after closure.
Anastomotic Leak ; Colostomy ; Constriction, Pathologic ; Enterocolitis ; Humans ; Ileostomy ; Length of Stay ; Necrosis ; Pathology ; Prolapse ; Retrospective Studies ; Risk Factors ; Skin ; Wounds and Injuries

Angiokeratoma circumscriptum is present at birth or early childhood and is an uncommon dermatosis characterized by papules and small nodules that may coalesce to form plaques. Histopathologically, there are varying degrees of hyperkeratosis, papillomatosis, and irregular acanthosis. In the papillary dermis, greatly dilated capillaries are observed, The acanthotic epidermis encircles the vascular spaces(blood cysts) where, occasionally, organized thrombi may be found. The use of pulsed-dye lasers to treat cutaneous vascular lesions is based on the theory of selective photothermolysis. We report a case of an angiokeratoma circumscriptum in an 48-year-old woman for whom the flashlamp pulsed tunable dye laser proved to be a highly successful means of treatment.
Angiokeratoma* ; Capillaries ; Dermis ; Epidermis ; Female ; Humans ; Lasers, Dye* ; Middle Aged ; Papilloma ; Parturition ; Skin Diseases

A umbilical omphalomesenteric duct polyp is the result of incomplete closure of the omphalomesenteric duct, which connects the midgut with the yolk sac of the embryo. It may be associated with underlying embryologic anomalies such as Meckels diverticulum and umbilical enteric fistula, the complications of which may at times be fatal. This rare malformation should be clinically discerned from persistent granulation tissue or pyogenic granuloma. Histologically, it shows a polypoid lesion consisting of ectopic gastrointestinal epithelium with the appearance of gastric, intestinal, or colonic mucosa. We report a case of an umbilical omphalomesenteric duct polyp in an 8-year-old male patient, who had had a bright-red polyp on the umbilicus from the age of 1 month and had not had any other types of underlying abnormalities.
Child ; Colon ; Diverticulum ; Embryonic Structures ; Epithelium ; Fistula ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Male ; Mucous Membrane ; Polyps* ; Umbilicus ; Vitelline Duct* ; Yolk Sac

A 51-year-old Korean woman presented with a non-tender, well-demarcated, reddish, edematous patch on the right anterior chest where a previous mastectomy and radiation therapy had been performed. She had been diagnosed as having infiltrating ductal carcinoma of the right breast about 1 year ago. Histopathological findings of the skin lesions were consistent with inflammatory metastatic carcinoma of the breast. Inflammatory carcinoma or carcinoma erysipeloides is a well-established entity most frequently associated with carcinoma of the breast. It is characterized by dermal lymphatic invasion by malignancy and clinically should be distinguished from erysipelas or cellulitis. We describe a case of inflammatory metastatic carcinoma derived from an infiltrating ductal carcinoma of the breast which can be clinically confused with radiation dermatitis.
Breast* ; Carcinoma, Ductal ; Cellulitis ; Dermatitis ; Erysipelas ; Erysipeloid ; Female ; Humans ; Mastectomy ; Middle Aged ; Skin ; Thorax

Favre-Racouchot syndrome is a disease of senile or actinic processes and another name is nodular elastosis with cysts and comedones. Clinically, facial skin shows, especially lateral to the eyes, multiple open and cystically dilatated comedones and can be defined as cutaneous disturbances characterized by a degenerative process of the dermis associated with cysts and comedones. Sunlight is a strong causative factor and dermal degenerative processes result in this condition. We report the case of a 78-year-old man who showed multiple yellowish papules on both sides of cheeks, the periorbital and, malar areas. He had had this condition for 25-years. His job used to involve physical labor and much exposure to sunlight. An excisional biopsy specimen from the facial malar lesion showed cystically dilated comedones with basophilically degenerated dermal tissue. We performed a therapeutic excision on the two large nodular lesions on both malar areas and applied topical tretinoin. The Patients clinical appearance was much improved 2 months later.
Actins ; Aged ; Basophils ; Biopsy ; Cheek ; Dermis ; Facial Dermatoses* ; Humans ; Skin ; Sunlight ; Tretinoin*

PURPOSE: The aims of this study were to assess the oncologic safety of laparoscopic colorectal surgery compared to that of conventional open surgery and to compare the disease-free survival (DFS) rates between laparoscopic and open colorectal surgery for radical treatment of colorectal cancer. METHODS: From January 2001 to December 2005, 583 patients underwent laparoscopic or conventional open surgery. To address only radical treatment of colorectal cancer, we excluded subjects who had undergone emergency or palliative operation. Four hundred ninety patients were identified for this study. The laparoscopic (LG) and open group (OG) had 74 and 166 patients, respectively, for colon cancer, and 92 and 158 patients, respectively, for the rectal cancer. RESULTS: No difference was noted in the lengths of the distal margins of the resected bowels between the LG and the OG for rectal cancer (P>0.05). In addition, no significant difference was found in DFS rates between the LG and the OG for both colon and rectal cancer (P>0.05). CONCLUSIONS: The laparoscopic technique does not seem to present any disadvantages and is safe and feasible for the treatment of colorectal cancer. No difference was found between laparoscopic and open surgery in terms of DFS for colorectal cancer.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Colorectal Surgery ; Disease-Free Survival ; Emergencies ; Humans ; Laparoscopy ; Rectal Neoplasms

PURPOSE: Because there are no significant differences of the clinical findings between the appendicitis and cecal diverticulitis, it is very difficult to make a correct diagnosis preoperatively and to choose a appropriate management intraoperatively. The purpose of this study is to investigate the clinical charateristics of right diveticulitis and to evaluate the appropriateness of surgical management. METHODS: We reviewed 45 cases of right colonic diverticulitis which underwent emergency operation under the impression of acute appendicitis during 10 years from January 1988 to December 1997. RESULTS: Of them, 38 cases were treated by diverticulectomy with appendectomy (Group I), and 7 cases were treated by resection (ileocecal resection or right hemicolectomy) (Group II). The male to female ratio was 4:1, and the mean age was 38.2 years. In Group I, all cases had a solitary inflamed cecal diverticulum. In group II, two cases had a solitary cecal diverticulitis, whereas five cases had multiple ones. Postoperative complications were found in 14 cases, but all of them were not significant. Postoperative Barium enema was performed in 22 cases of Group I, in two cases of Group II. In Group I, 8 cases had a residual diverticulum at postoperative Barium enema. In Group II, no residual diverticulum was shown. Follow-up study by Telephone was done at 16 cases, there were no symptomatic recurrences. CONCLUSIONS: In conclusion, when right colonic diverticulitis is found at the time of operation, surgical management is a safe treatment with low morbidity and low recurrence rate. Diverticulectomy with appendectomy is a safe surgical procedure for the uncomplicated diverticulitis. If diverticulitis is complicating, multiple or undistinguishable with malignancy, resection (ileocecal resection, right hemicolectomy) should be considered as a primary surgical treatment. Postoperative colon study is helpful, due to high incidence of residual diverticulum.
Appendectomy ; Appendicitis* ; Barium ; Colon* ; Diagnosis ; Diverticulitis ; Diverticulitis, Colonic* ; Diverticulum ; Emergencies ; Enema ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Postoperative Complications ; Recurrence ; Telephone

BACKGROUND: In the cutaneou; neoplasms, especially melanocytic skin lesions, the degree of the nuclear atypia such as the hyp rchromatism, pleomorphism, and giantism is a very impor tant factor when determining the differntial diagnosis between the malignant. and the benign turnors and the prognosis. OBJECTIVE: So we measured and cornpared the nuclear atypia of the malignant melanoma, and acquired and congenital melanocytic nevi(AMN and CMN) using the computerized image analysis (IA). METHODS: Five micron sections were cut from each paraffin block. The sections were Feulgen-stained and image analysis was perforrned with an AIC image analysis system. In each case, 50 lymphocytes nuclei fnim the sarne specimen slide were measured as an internal diploid control. Each 100 cells of the MM, CMN and AMN were measured and are referred to in this report as the upper part and the lower part. The morphological parameters such as mean nuclear area, coefficient of variation(CV) of the nuclear area, roundness of the nucleus and CV of the roundness were measured. For the nuclear content, mean ploidy, CV of the mean ploidy ind 2c Deviation Index(2cI3I) were calculated and then the DNA histograms were produced. RESULTS: Nuclear area, CV of the nuclear area, mean ploidy, CV of the mean ploidy and 2cDI were found to be significantly reat.er for rnalignant melanoma than for CMN and AMN. The nuclear area of AMN is significantly lar ger than that of CMN and there were no significant differences between the uper and the lower parts of three melanocytic lesions in any of the measured parameters. CONCLUSION: The results of o ir study suggest that the IA of the melanocytic cells might reflect the biologic behavior rnore sensitively than do clinical or histologic criteria, therefore important information for differentiating thi benign and the malignant melanocytic lesions may be obtained by the DNA profile and morphomi try on Feulgen stained tissue specirnens using IA.
Diagnosis ; Diploidy ; DNA* ; Lymphocytes ; Melanoma ; Paraffin ; Ploidies* ; Prognosis ; Skin*

Although there are still controversies about whether hypertriglyceridemia is an independent risk factor for coronary artery disease, recent analysis reported hypertriglyceridemia and central obesity are independent risk factors for coronary artery disease. However, the prognostic impact of hypertriglyceridemia and central obesity in acute myocardial infarction (AMI) patients underwent percutaneous coronary intervention (PCI) are still remained unclear. In this issue, Han et al. investigated the prognostic impact of hypertriglyceridemia and/or central obesity on baseline in AMI patients treated with PCI. In this editorial, we have reviewed the role of hypertriglyceridemia and central obesity on the prognosis after PCI in AMI patients. Although hypertriglyceridemia and central obesity on baseline in this study had no role on the prognosis following PCI in AMI patients, to confirm for these results, further studies on this topic will be warranted in the future.
Coronary Artery Disease ; Humans ; Hypertriglyceridemia* ; Myocardial Infarction* ; Obesity, Abdominal* ; Percutaneous Coronary Intervention* ; Prognosis ; Risk Factors